Isolation of bacteriophages to multi-drug resistant Enterococci obtained from diabetic foot: A novel antimicrobial agent waiting in the shelf?

Vinodkumar, CS; Srinivasa, H; Basavarajappa, K G; Geethalakshmi, S. N.; Bandekar, Nitin

doi:10.4103/0377-4929.77333

Cited by 21 publications

(14 citation statements)

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“…About 30% of the enterococcal strains isolated from our patients were revealed as high level aminoglycoside resistant (HLAR); in contrast, there were no alarm strains resistant to glycopeptides (VRE -vancomycin-resistant Enterococcus). These values are lower than previously presented in the available literature [14][15][16][17]. In most cases the material was obtained immediately on admission to the clinic, and a relatively low fraction of HLAR strains were recovered, both of which contradict the nosocomial source of enterococcal infection.…”

Section: Discussioncontrasting

confidence: 48%

Etiological Factors of Infections in Diabetic Foot Syndrome – Attempt to Define Optimal Empirical Therapy

Małecki¹,

Rosiński²,

Adamiec³

2014

Adv Clin Exp Med

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Background. Diabetic foot syndrome (DFS) represents one of the most frequent reasons for lower limb amputation in developed countries. In most cases, it is associated with bacterial infection, requiring optimal antibiotic therapy. Objectives. The aim of this study was to identify the most frequent pathogens responsible for infections associated with DFS, establish the optimal protocol of empirical therapy, and ascertain the clinical variables that may determine the choice of the appropriate antibacterial agent. Material and Methods. The analysis included hospital records of patients treated at the Department between 2008 and 2010. A total of 102 individuals were identified; their material was cultured and tested for antibiotic susceptibility. Results. A total of 199 bacterial strains were isolated. There was a predominance of Gram-positive bacteria, particularly Staphylococcus aureus, Staphylococcus coagulase-negative strains, and Enterococcus faecalis. Of note was the high percentage of E. faecalis infection (16.08%). One can speculate on the potential etiological factors in the case of some bacteria, e.g. patients infected with S. aureus were characterized by higher monocytosis and lymphocytosis as compared to other patients. Analysis of drug susceptibility revealed that ciprofloxacin has the highest (but still only 44%) efficacy of all agents tested as monotherapy, and a combination of piperacillin and tazobactam or amoxicillin and clavulanate with aminoglycosides is particularly beneficial. Conclusions. Staphylococcus spp. predominates amongst the etiological factors of DFS infection; however, the rate of E. faecalis infection is alarmingly high. Monotherapy enables effective treatment in a minority of cases; therefore, at least two-drug protocols should be implemented from the very beginning of the therapy (Adv Clin Exp Med 2014, 23, 1, 39-48).

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Section: Discussioncontrasting

confidence: 48%

Etiological Factors of Infections in Diabetic Foot Syndrome – Attempt to Define Optimal Empirical Therapy

Małecki¹,

Rosiński²,

Adamiec³

2014

Adv Clin Exp Med

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“…This can be attributed to the fact that these organisms have been exposed to multiple antibiotics in hospital settings, thus providing them with an evolutionary pressure for selective advantage (reviewed in Moellering, 1992). As already stated, the enterococci have evolved mechanisms for the transfer of resistance genes through exchanging plasmids via conjugation, as well as exchanging resistance genes on transposons or via bacteriophages (Clewell, 1990;Dunny, 1990;Scott, 1992;Clewell, 1993;reviewed in Jett et al, 1994;Mazaheri Nezhad Fard et al, 2011;Vinodkumar et al, 2011). Mutations can also lead to high-level resistance to various antibiotics.…”

Section: Antibiotic Resistance To Antimicrobial Agentsmentioning

confidence: 94%

“…Finally, the last conjugative system involves transposons found in Gram-negative and Gram-positive bacteria (reviewed in Scott, 1992 andPalmer et al, 2010). Apart from these conjugative systems, infection with bacteriophages is another method of genetic material exchange used by enterococci to allow for the spread of virulence factors or antibiotic resistance (Mazaheri Nezhad Fard et al, 2011;Vinodkumar et al, 2011).…”

Section: Pathogenesismentioning

confidence: 99%

Enterococcus: review of its physiology, pathogenesis, diseases and the challenges it poses for clinical microbiology

Carvalho

2011

Front. Biol.

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The genus Enterococcus is composed of 38 species, the most important of which are Enterococcus faecalis and Enterococcus faecium-both human intestinal colonizers. Hospitals within the United States and around the world commonly isolate these bacteria because they are a cause of bacteremia, urinary tract infections (UTIs), endocarditis, wound infections, meningitis, intraabdominal and pelvic infections, and nosocomial and iatrogenic infections. Given the ubiquity of enterococci within the human population, it is important for laboratories to be able to distinguish these agents within hospitalized patients from other bacterial genera and also differentiate different species within the Enterococcus genus as well as different strains within each species. Unfortunately, the enterococci are emerging as serious pathogens in both the developed world, where surveillance needs to be improved and speciation procedures are inadequate or cumbersome, and in developing nations, which lack the trained hospital personnel or funding to sufficiently identify enterococci to the genus or species level. This review explores the Enterococcus genus and highlights some of the concerns for national and international clinical microbiology laboratories.

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“…from 287 microorganisms isolated from diabetic foot infections. In India, Vinodkumar et al, (2011) found that a whole of 65.6% of Enterococcus spp. were isolated from diabetic foot infections with high level aminoglycoside resistance (HLAR).…”

Section: Enterococcus Virulence Genesmentioning

confidence: 99%

“…In Germany, Werner et al, (2012) stated that 64 E.faecalis and 37 E. faecium isolates did not show a particular multi resistance phenotype and resistances to glycopeptides and antibiotics. Moreover, in India, Vinodkumar et al, (2011) conveyed that a total of 65.6% of Enterococcus spp. showed HLAR.…”

Section: Aminoglycoside Resistancementioning

confidence: 99%

History, Virulence Genes, Identification and Antimicrobial Resistance of Enterococcus faecalis Isolated from Diabetic Foot Patients

Bloushy¹,

Elbehiry²

2018

Int.J.Curr.Microbiol.App.Sci

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Isolation of bacteriophages to multi-drug resistant Enterococci obtained from diabetic foot: A novel antimicrobial agent waiting in the shelf?

Cited by 21 publications

References 0 publications

Etiological Factors of Infections in Diabetic Foot Syndrome – Attempt to Define Optimal Empirical Therapy

Etiological Factors of Infections in Diabetic Foot Syndrome – Attempt to Define Optimal Empirical Therapy

Enterococcus: review of its physiology, pathogenesis, diseases and the challenges it poses for clinical microbiology

History, Virulence Genes, Identification and Antimicrobial Resistance of Enterococcus faecalis Isolated from Diabetic Foot Patients

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